Gut Microbiome And Acute Rejection After Kidney Transplantation

H. Cho¹, Y. Yang¹, J. Kim², J. Moon², J. Jeong², J. Park³, M. Kwak⁴, B. Kim⁴, D. Kim², J. Lee⁵, B. Kim⁶, Y. Kim², H. Lee²

¹Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea, Republic of, ²Internal Medicine, Seoul National University Hospital, Seoul, Korea, Republic of, ³Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea, Republic of, ⁴ChunLab Inc., Seoul, Korea, Republic of, ⁵Internal Medicine, Seoul National University, Boramae Hospital, Seoul, Korea, Republic of, ⁶Hallym University, Chuncheon, Korea, Republic of

Meeting: 2019 American Transplant Congress

Abstract number: A26

Keywords: Infection, Kidney transplantation, Prognosis, Rejection

Session Information

Session Name: Poster Session A: Acute Rejection

Session Type: Poster Session

Date: Saturday, June 1, 2019

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Hall C & D

*Purpose: Acute rejection (AR) is a common complication in kidney transplantation (KT) and associated with reduced patient-graft survival. Recent studies have shown that the gut microbiota modulates the host immune system and is related to complications in transplant recipients, although there are only a few studies on the associations between the microbiota composition and acute renal allograft rejection. Here, we aimed to evaluate the impact of the gut microbiota on acute rejection after KT.

*Methods: We prospectively enrolled renal transplant recipients and collected stool specimens before and 3 months after transplantation in two tertiary centers. Metagenomic DNA was isolated from feces, sequenced using by Illumina MiSeq system, and analyzed for microbial composition. We investigated the association between preKT and 3 months after KT fecal microbiomic composition and biopsy-proven AR within a year after KT.

*Results: A total of seventy‐nine recipients were included in the final analysis. The mean age was 49.1 ± 12.1 years and 45 (57.0%) were men. Among them, 31 (39.2%) experienced AR by either protocol or indication graft biopsies. In pre-transplant fecal samples, the Shannon diversity index as makers of microbial diversity had no significant difference between the AR and the no AR groups. Three bacterial groups showed significant decreases in patients who experienced a rejection compared to patients who never experienced a rejection. The corresponding genera were Phascolarctobacterium (p=0.006), Parabacteroides (p=0.049) and Citrobacter (p=0.049, Wilcoxon rank-sum test). In 3-month post-transplant samples, the Shannon diversity index was lower in the AR group than the no AR group with a near significance (p=0.06). The only Phascolarctobacterium was significantly decreased in patients with rejection (p=0.014).

*Conclusions: Specific pretransplant gut microbiota is associated with acute rejection after KT and could serve as diagnostic markers for the prediction of transplant outcome. Future studies should be aimed at identifying the mechanisms of immune modulation by gut microbiota.

To cite this abstract in AMA style:

Cho H, Yang Y, Kim J, Moon J, Jeong J, Park J, Kwak M, Kim B, Kim D, Lee J, Kim B, Kim Y, Lee H. Gut Microbiome And Acute Rejection After Kidney Transplantation [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/gut-microbiome-and-acute-rejection-after-kidney-transplantation/. Accessed May 21, 2025.

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